认知-行为治疗对国人肠易激综合征疗效的Meta分析  

Meta-analysis on effectiveness of cognitive-behavioral therapy for irritable bowel syndrome in China

作　　者：杨静[1] 雷晓斐[1] 李坤[1] 李双玲[1] 徐昌青[1] 杨宏丽[1] 

机构地区：[1]山东省千佛山医院消化内科,济南250014

出　　处：《中华消化病与影像杂志（电子版）》2017年第2期66-74,共9页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：国家自然科学基金青年科学基金(81200275);山东省自然科学基金(ZR2012HL20;ZR2014HL068)

摘　　要：目的评价认知-行为治疗对中国人群肠易激综合征患者治疗效果。方法计算机并手工检索Pub Med、Cochrane Library、Embase、中国期刊全文数据库、中国生物医学文献数据库、万方数据库中关于认知-行为治疗中国人群肠易激综合征(irritable bowel syndrome,IBS)的随机对照研究,检索文献检索时限均从建库至2016年4月30日。纳入文献进行质量评价及资料提取后,使用Review Manager 5.3软件对数据进行Meta分析。结果共纳入9项随机对照研究,907例患者。Meta分析结果显示:认知-行为治疗联合常规药物治疗,相对于单独药物治疗,在国人IBS总体症状有效率(RR=1.16,P=0.0002)、焦虑/抑郁评分(SMD=-0.96,P=0.004;SMD=-0.86,P=0.03)、生活质量评价如社会功能、人际关系、健康忧虑、行为障碍等维度(P<0.05)均有显著改善作用。但单独认知-行为治疗相对于常规药物治疗,对国人IBS总体症状有效率的作用差异无统计学意义(RR=0.95,P=0.41)。结论在常规治疗基础上联合认知-行为治疗能有效改善中国IBS患者的临床症状和心理状态,并提高生活质量。单用认知-行为治疗相对于常规治疗对IBS症状改善无显著差异。Objective To evaluate the effectiveness of cognitive-behavioral therapy（ CBT） for the treatment of irritable bowel syndrome （IBS） patients in China. Methods Publications on the randomized controlled trials （ RCTs） of CBT for the treatment of IBS patients in China from the databases including PubMed,Cochrane Library,EMBase,CNKI,CBM and WanFang data were searched up to April 30,2016. The selected articles were evaluated for the methodological qualities and the related data were extracted for further Meta-analysis by Review Manager 5. 3. Results A total of 9 RCTs involving 907 patients were included. Results of Meta-analysis showed that compared with the monotherapy of usual drugs,the combination of CBT and usual drugs was statistically better in the improvements of overall symptom effective rates of IBS （ RR = 1. 16 = 0. 000 2） ,anxiety/depression scores （ SMD = - 0. 96, P = 0. 004 ; SMD = - 0. 86, P = 0. 03 ） andthe overall quality of life such as social functions, interpersonal relationships, health worry and interference with activity（P 〈0. 05） in Chinese population. But the monotherapy of CBT was not superior to usual drugs in the improvement of overall symptom effective rates （RR =0. 91,P=0. 15）. Conclusion The combination of CBT and usual therapy can significantly improve the overall symptoms, psychological states and life quality of IBS patients in China. The monotherapy of CBT is not significantly superior to usual therapy in the improvement of IBS symptoms.

关 键 词：肠易激综合征 认知疗法 META分析 

分 类 号：R574[医药卫生—消化系统]